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Katherine Sibler, Nurse Practitioner with the Vanderbilt Breast Center, ​discusses Breast Cancer Awareness. She describes awareness as knowing the facts about breast cancer including the risk factors, knowing how to reduce your risk, knowing the symptoms of breast cancer, and what types of screenings are available, including those at Vanderbilt.

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Bridgette Butler: Welcome to this edition of the Vanderbilt Health and Wellness Wellcast. I am Bridgette Butler with Health Plus. October is Breast Cancer Awareness Month and today I am speaking with Katherine Sibler, Nurse Practitioner, with the Vanderbilt Breast Center. Welcome, Katherine!

Katherine Sibler: Thank you for having me!

Bridgette Butler: To start with the basics, what is breast cancer?

Katherine Sibler: Breast cancer occurs when cells divide and grow without their normal control. If abnormal cells grow inside the milk ducts, but don’t spread to nearby tissue, this is called ductal carcinoma in situ or DCIS. Invasive breast cancer occurs when cancer cells spread to nearby tissue or other parts of the body. Whenever a cancer spreads to somewhere else in the body, then it is considered metastatic breast cancer.

Bridgette Butler: What are the risk factors for breast cancer?

Katherine Sibler: There are some risk factors that we simply cannot change. The two most common are being a woman and getting older. There are some other factors that, again, we cannot change including certain inherited genes such as the BRCA-1 or -2 mutations, family history, breast density, gynecological history, having radiation to your chest; things like that. But then there are some lifestyle-related breast cancer risk factors that we can change including drinking alcohol, being overweight or obese, and being physically active.

Bridgette Butler: It sounds like it’s possible to lower your risk of breast cancer. Is it and how do we reduce our risks?

Katherine Sibler: We certainly can try to implement lifestyle changes to help reduce our risks such as limiting alcohol intake. Studies do show that the more you drink, the higher your risk, just as much as 2-3 glasses of alcohol a day can increase a woman’s risk by 20% and so the general recommendation is to limit yourself to less than one drink a day, one ounce of liquor or six ounces of wine or eight ounces of beer. Then, in general, don’t smoke. Control your weight; being overweight or obese can increase the risk of breast cancer, especially true if obesity occurs later in life, particularly after menopause. And then we want you to be physically active. Increased levels of physical activity have been associated with a decreased risk of breast cancer. We recommend at least 150 minutes a week of moderate aerobic activity. Just get your heart pumping! And then there are certain instances where women are at increased risks based on strong family history or genetic mutations. In those populations, we may talk about additional management options including medications that can sometimes reduce your risk, but, of course those come with side effects so we really have to talk about risks and benefits with those medications and even more rare circumstances where someone is at very high risk, we may talk about preventative surgery. But, in general, we recommend everyone do those lifestyle modifications.

Bridgette Butler: It sounds like there are a lot of lifestyle changes that we can make to reduce our risks. Now, what are the symptoms of breast cancer that one should be aware of?

Katherine Sibler: The warning signs of breast cancer are not the same for all women. The most common signs are a change in the look or feel of the breast, a change in the look or feel of the nipple, and nipple discharge. In many cases, there may not be any signs, which is why it is important to undergo regular mammograms and just be aware of your normal breast tissue.

Bridgette Butler: So that leads in to my next question, which is what types of screenings are available for breast cancer?

Katherine Sibler: For a woman with an average risk of developing breast cancer, the NCCN Guidelines, which stands for The National Comprehensive Cancer Network, recommends mammograms every year starting at age 40 for as long as a woman is in good health. This may be done in combination with digital tomosynthesis or 3D mammography if a woman has dense breast tissue. For a woman with an increased risk of developing breast cancer based on family history or other circumstances, we may consider additional screening tools such as an MRI of the breast. We do have walk-ins available at the Vanderbilt Clinic for screening mammograms and an order is not needed for screening.

Bridgette Butler: That’s a great resource that is available to the Vanderbilt community. Are there additional resources that are available at Vanderbilt or in the community at large?

Katherine Sibler: The Vanderbilt Breast Center has a handful of nurse practitioners such as myself both at 100 Oaks and now at Cool Springs (we recently opened a breast clinic). We are always happy to see patients for evaluation of breast symptoms, concerns, or even for discussion of breast cancer risks based on certain criteria. Some reliable and easily accessible resources are the American Cancer Society and Susan G. Komen, but we are always available for patients or for staff, if needed.

Bridgette Butler: Thank you, Katherine, for helping us better understand breast cancer, how to lower our risk, the important screenings to be watching for and resources available at Vanderbilt. I appreciate your time today.

Katherine Sibler: Thank you!

Bridgette Butler: Thanks for listening! Please feel free to leave us any comments on this Wellcast on the form at the bottom of this page. If you have a story suggestion, please email it to us at health.wellness@vanderbilt.edu or you can use the “Contact Us” page on our website at healthandwellness.vanderbilt.edu